November 19,2003

Grassley on the Benefits to Rural America in the Medicare Agreement

Statement of Sen. Chuck Grassley
Chairman, Committee on Finance
on the Benefits to Rural America in the Medicare Legislation Conference Agreement
Wednesday, Nov. 19, 2003

We’re closer than ever to the most dramatic improvement in rural health care any Congress has ever considered: A $25 billion commitment over 10 years. I want to quickly review how we go there. Last year, Senator Baucus and I put together a bipartisan package of rural health care improvements when it became clear we couldn’t get a drug bill done. But the Baucus/Grassley bill never got an up or down vote. Still, we’ve been committed to staying the course and finishing thejob ever since. This year, we worked to include a rural package that was not paid for with money for prescription drugs. Our provisions are offset by other program changes, not by seniors’ prescription drug money.

We were the leaders on this. Only after we succeeded in attaching our package to the tax billin May – on a vote of 86-13 – did the President and the House take notice and change their tune.

Our package was dropped from the tax conference, but we got a letter from the White Housepledging its full support. Then, the House mimicked most of our policies in its drug bill, eventhough many of its urban members were opposed. So both bills wound up with basically the samesolid rural package. The Senate was the driving force for this. This conference report includes thebest from both bills. It makes great strides in truly improving rural inequities.

These formulas have been held hostage for too long by powerful committee chairmen frombig cities. As a result, the payments have favored urban areas at the expense of rural states. Thisconference agreement begins to end that favoritism once and for all. That, in and of itself, is trulyremarkable. Under the agreement, hospitals, doctors, home health agenices, and ambulancecompanies in states like Iowa will see dramatic improvements in their Medicare payments. “Equalpay for equal work” is a guiding principle here. And we’ve made great strides toward that goal.

These rural equity issues are bipartisan, and bicameral. They have the support of the President ofthe United States. But most importantly, they have the strong support of the people who live andwork in rural America. And that, more than any presidential pronouncement, is why we are standinghere so close to victory today. I am urging all of my colleagues, Republican and Democrat, fromstates like mine to understand that this is the best thing rural America has ever seen when it comesto improving Medicare equity. I think they’ll each be hard-pressed to explain why they walked awayfrom this if they vote against our overall bill.